TRANSPORT REWE TITLE by kRCH LABORATORY Towards a strategy for improving road safety in developing countries G 0 Jacobs and C J Baguley Overseas Centre Transport Research Laboratory Crowthorne Berkshire United Kingdom 1. JACOBS, G D and C J BAGULEY (1 995). Towards a strategy for improving road safety in developing Countries. International Seminar on Road Safety, BRTA, Dhaka, Bangladesh, October 1995.- PA 3089/95 Bangladesh Seminar 1995 TOWARDS A STRATEGY FOR IMPROVING ROAD SAFETY IN DEVELOPING COUNTRIES by G D Jacobs & C J Baguley Overseas Centre Transport Research Laboratory, UK 1. INTRODUCTION Independent studies by both the World Health Organisation and the World Bank (1990) have estimated that about 500,000 people lose their lives each year as a result of road accidents and over 15 million suffer injuries. The majority of these, about 70 per cent, occur in those countries which the World Bank classifies as low or middle income. Whereas the road accident situation is slowly improving in the high income countries, most developing countries face a worsening situation. As infectious diseases are brought increasingly under control, road deaths and injury rise in relative importance. In Thailand for example, more years of potential life are lost through road accidents than from tuberculosis and malaria combined (Yerrell, 1992); in Mexico, accidents as a cause of death rose from 4 per cent in 1955 to 1 1 per cent in 1980, with traffic accidents playing the leading role. The authors believe that this is not the inevitable price that has to be paid by these countries for the mobility of people and goods, but that there is much scope for improving their road safety situation whilst developing into a mnore industrialised society. This paper presents a broad review of the road safety problems in developing countries as a thorough understanding of these must be gained before an effective improvement strategy can be devised. Recommendations for improvement are included, based on the detailed research carried out by the Overseas Centre at the Transport Research Laboratory (TRL) over the last 20 years. 2. BACKGROUND Studies carried out by the TRL have demonstrated that road accidents in the Third World are: (I) A serious problem in terns of fatality rates, with rates at least an order of magnitude higher than those in industrialised countries (Jacobs, 1986). (ii) An important cause of death and injury. (iii) A considerable waste of scarce financial (and other) resources, typically costing at least one per cent of a country's gross national product per annum. (Fouracre and Jacobs, 1976). 2.1 Rates and trends The rate used by TRL to compare the seriousness of the road accident problem in different countries 21 throughout the world is the number of deaths from road accidents per annum per 10,000 vehicles licensed. This is far from ideal as an indicator of relative safety in different countries. For example, the injury accidents per million vehicle-km travelled per annum may be a much better parameter to use but, unfortunately, the reporting of non-fatal accidents in most Third World countries is poor and few carry out traffic surveys and censuses which provide information on annual travel by different classes of vehicle. Fig. 1 Road Accident Fatality Rates (deaths/10,000 registered vehicles) in selected countries (from latest data available from 1989-1993) Results for a number of countries (1989-93) are shown in Figure 1. It can be seen that whilst countries of Western Europe and North America are characterised by a death rate (as defined above) of often less than 2, some developing countries have a death rate in excess of 150. In most developing countries there will be an under-reporting of road accident deaths and an over-estimate of licensed vehicles because as vehicles are scrapped they tend not to be removed from the vehicle register. In a recent study in Bangladesh it was estimated that for the reasons given above, the actual fatality rate may be at least 50 per cent greater than the officially quoted figure of 60. In 1984, TRI, carried out a study in Colombo, Sri Lanka, comparing 'official' road accident statistics from police records with those held by hospitals. It was found that less than 25 per cent of the hospital records (of fatal and serious road accidents) were identified in the police data. Matching of accidents involving children was particularly low. Studies such as these suggest that the road safety 2 200- 180. .160~~~~15 -~~~~ 14~~~~0.3 a140~~~~~~~1 ~1 2 0 -- 1. . .. . . . . .. . . . .. . . . . 6 1 0 0 .. . . . . . . . . . . . -- - - a80 -7. * 60 -8 46 LL 1 ~~~~~~~~~~~44.4 40- [Cr127.S 26.7 20 ~~~~~~~~~~~~~~ 2~~~~~2 20- 1. T 1.2.. C,. problem in developing countries may be much worse than official statistics suggest. Figure 2 Percentage change in road accident fatalities over 22-year period Figure 2 shows the percentage increase or decrease in the actual number of road accident fatalities over the period 1968 to 1990 for four groups of countries. It can be seen that over this given time period the number of road accident deaths in 14 developed countries actually fell on average by 30 per cent. Conversely in 6 Asian countries and 12 African countries (for which reasonably accurate statistics were available) there were increases of about 200 and 340 per cent respectively. In these countries, therefore, there is obvously need for much effort and investment in safety measures to reverse this trend -as has been the case in the developed world. 2.2 The importance of road accidents as a cause of death In cooperation with the World Health Organisation, an early study (Jacobs and Bardsley, 1977) compared deaths from road accidents in selected developing countries with other causes of death, including diseases considered to be of concern in the Third World. Information was obtained from 15 countries which tended to be at the top end of the 'Third World spectrum' (such as Jamaica, Colombia, Peru, Malaysia, Brazil, Venezuela, South Africa, etc) which could not be said to be representative of the entire Third World. The results nevertheless are of interest in that they show that in these countries road accidents were by no means insignificant as a cause of death. For all age 3 d- uu- (D ~~~~Average of ()countries U)250- (00) 200- E ~~~~~~~~~~~~~Asia &Middle East (6) 0'=150- ~100+ 00- 0)0 1968 19d72 19d76 19d80 1984 19d88 1992 groups combined, road accidents were the tenth most important cause of death (behind causes such as bronchitic, circulatory, parasitic and infectious, enteric, etc). For the age group 5-64 years, road accidents were the sixth most important cause of death and for the age group 5-44 years they were second in importance (to other accidents, suicides and homicides combined). This analysis was used to show that even twenty years ago, road accidents in developing countries were already a growing social problem. Another important factor affecting the number of people killed in road accidents in developing countries is the level of medical facilities available. Thus in Western Europe with good ambulance services, road accident casualties are very quickly taken to hospital to receive immediate attention. Even before reaching hospital trained paramedic services mean that expert assistance can be provided at roadside. Another useful measure of the seriousness, of the road accident problem in a country is the Fatality Index (F1), ie the percentage of all casualties that are fatally injured. In a study carried out by TRL (Jacobs and Hutchinson, 1973) the FL was determined for 32 (mainly) developing countries and was found to range from about 4 (Cyprus, Mauritius) to over 20 (Pakistan, Iraq). Reasons for high FIs were investigated by means of regression analysis and it was found that the level of medical facilities available in these countries (expressed as population per physician and population per hospital bed) were very closely 'correlated with the, FL, the poorer the medical facility as defined above, the higher the FL. Clearly the level of medical facilities available in developing countries has a significant impact on the number of people dying in road accidents. By improving medical services generally, including ambulances and trained paramedics, the number of people injured in road accidents who subsequently die can be significantly reduced. 2.3 The cost of road accidents Apart from the humanitarian aspects of road safety, it must also be borne in mind that road accidents are responsible in developing countries for a loss of scarce financial resources that these countries can ill-afford to lose. An analysis carried out by TRL (Fouracre & Jacobs, 1976) showed that road accident costs were the equivalent in any country, be it developed or developing, to approximately 1 per cent of its annual gross national product. In current prices this suggests that road accidents in Indonesia for example may be costing about £600 million per annum, in Pakistan £260 million, in Egypt £200 million, in Chile £150 million, in Kenya £60 million, etc. If one assumes road accidents to cost 1 per cent of GNP in all countries, then for those countries of Africa and Asia below an average GNP/capita of $3,500 (figure used by the World Bank to define 'developing' countries), it is estimated that the total annual cost of road accidents is approximately US$30 billion. If the reduction in the substantial pain, grief and suffering caused by road accidents in the Third World is not sufficient motivation, there is also a very strong economic case to be made in the significant loss of resources each year due to accidents. Unfortunately, road safety is but one of the many problems demanding its share of funding and other resources in developing countries. Even within the boundaries of the transport and highway sector, hard decisions have to be taken on the resources that a Third World government can devote to road safety. In order to assist in this decision-making process it is essential that a method be devised to determine the cost of road accidents and the value of preventing them. 4 So, the first need for cost figures is at the level of national resource planning to ensure that road safety is ranked equitably in terms of investment in its improvement. Fairly broad estimates are usually sufficient for this purpose, but must be compatible with the competing sectors. For example, in a recent road safety study undertaken in a particular country by TRL, it was shown that the annual cost of road accidents nationally was about £20 million. A series of safety improvements was outlined which, it was estimated, would reduce the national cost of accidents by 5 per cent per annumn (ie saving £1 million per annum). These improvements (in highway design and layout, education, training and enforcement) were estimated to cost £500,000 in a programnme of measures set out over a 5 year period (ie at an average annual cost of £100,000). The average First Year Rate of Return on investment was therefore about 1000 per cent and the Benefit: Cost ratio about 10: 1. High rates of return such as these are fairly common in road safety appraisals and, quite apart from the humanitarian aspects, illustrate the economic benefits of investing in national road safety programmes. A second need for road accident cost figures is to ensure that the best use is made of any investment and that the best (and most appropriate) safety improvements are introduced in terms of the benefits that they will generate in relation to the cost of their implementation. Failure to associate specific costs with road accidents will almost certainly result in the use of widely varying criteria in the choice of measures and the-assessment of projects that affect road safety. As a consequence it is extremely unlikely that the pattern of expenditure on road safety will, in any sense be 'optimal'. In particular, if safety benefits are ignored in transport planning then there will inevitably be an under-investment in road safety. TRL has recently produced a document (1995) outlining methods that can be used by developing countries to cost road accidents. 3. THE NATURE OF THE ROAD ACCIDENT PROBLEM 3.1 Accident Patterns There are some accident characteristics which are common to a number of developing countries and yet are somewhat different from those in developed countries. For example, in the Third World (see Fig 3 and Table 1), a relatively high proportion of fatalities are pedestrians and children aged under 16 years, and many fatal accidents involve trucks, buses and other public service vehicles (see Downing,1991). In many cases these higher percentages are an obvious consequence of the differences between the traffic and population characteristics of developed and developing countries. For example, the average percentage of the population aged 5 to 14 years in a sample of 16 developing countries was 28 per cent compared with 15 per cent for 9 developed countries (Downing and Sayer, 1982). As pedestrians, children and professional drivers constitute such a large proportion of the accident problem, it is clear that many Third World countries need to give priority to improving the safety of these particular three groups. 3.2 Contributory Factors In most countries, police road accident reports give some information about the factors or causes which contributed to the accidents. In general these data have to be treated with some caution as the police investigating the accidents are unlikely to have been trained as engineers and they may therefore 5 60'i Figure 3 Pedestrian fatalities as a percentage of all road accident fatalities TABLE 1 Characteristics of fatal accidents 6 5 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . U) CD 4 0 . . . . . .. . . . . . .. . . ..-. 0 0 ) Euoe& SEAi A eia Ai fia Caiba ideEs S C ~ i 4 1 3 9 3 5 a,~ ~ ~ ~ ~ ~ ~ Nme o onre Country Percentage of fatalities which: were children under involved trucks 16 years and buses Botswana (1988) 16 25 Egypt (1984) 12 37 Ghana (1989) 28 50 Pakistan (1988) 14 44 (Karachi) Papua New Guinea (1987) 20 37 Zimbabwe (1989) 11 45 United Kingdom (1988) 9 21 underestimate the contribution made by road engineering problems. Their main aim is usually to determine whether these has been a traffic violation and therefore the emphasis of the investigation is likely to be placed on detecting human error and apportioning blame. In the United Kingdom in the early 1970s a more reliable approach, namely 'On-the-Spot' investigation, was carried out by a research team from TRRL in an area of South East England (Sabey and Staughton, 1975). This study demonstrated the importance of the road-user factor which contributed to 95 per cent of the accidents and the strong link between road-user error and deficiencies in the road environment, which together contributed to over 25 per cent of accidents (see Table 2). TABLE 2 Causes of road accidents as determined by the -police in developing countries _________ Main Cause of Accident(% _____ Country Road-user Vehicle Adverse road Country ~error defect conditions Other or ____ ___ __ ___ ___ ___ environm ent Afghanistan 74 17 9 - 19 84 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Botswana 94 2 1 3 19 82 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Cyprus 94 1 5 - 1982 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Ethiopia 81 5 - 14 1982 _ _ _ _ _ _ _ _ _ _ _ _ India 80 7 1 12 1980 _ _ _ _ _ _ _ _ _ _ Iran 64 16 20- 1 9 8 4 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Pakistan 91 4 5- 1984 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Philippines 85 8 7 - 19 8 4 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Malaysia 87 2 4 7 1 9 85_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Zimbabwe 89 5 1 5 1 9 7 9 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ TRRL On-the-I 1975* jtd 95 8 28 J____ *In about 30% of accidents, multiple factors were identified 7 Constraints of expertise or funding currently prevent a study of this type in developing countries, so police reports are the only source of information available. From Table 2 it can be seen that, in general, the data highlight the seriousness of road-user errors in developing countries but give little indication of any road environment factor other than in the case of Iran. It seems likely that the road environment factor has been considerably underestimated by the police in their statistics. The condition of main roads is poorer in developing than in developed countries (see, for example, Harral and Faiz, 1988) and the pace of introducing engineering improvements to reduce road accidents is considerably slower in the Third World. 3.3 Road User Behaviour and Knowledge Studies of road-user behaviour (Jacobs et al, 1981) at traffic signals and pedestrian crossings in a number of Third World cities indicated that road-users tended to be less disciplined than in the United Kingdom. Also, observations in Pakistan (Downing, 1985) demonstrated relatively high proportions of drivers crossing continuous `no-overtaking` lines (15 per cent) and not stopping at stop signs even when traffic was-near (52 per cent). Although the relationship between these differences in behaviour and accidents has not been determined, the results suggest that road safety measures which are not self enforcing, such as road signs and markings, may be much less effective unless they are integrated with publicity and enforcement campaigns. Poor road-user behaviour exhibited by drivers in some developing countries may be due to their lack of knowledge about road safety rules and regulations or their general attitude towards road safety matters. A study of drivers' knowledge in Jamaica, Pakistan and Thailand (Sayer and Downing, 1981) indicated that there were only a few topics where a lack of knowledge was widespread. One such example was stopping distances where 87 per cent of the drivers underestimated the distance required to stop in an emergency when travelling at 30mph. Answering questions on stopping and following distances also proved to be a problem for professional drivers in Cameroon and Zimbabwe (Downing, 1991), with truck and bus drivers unable to answer more than half the questions on driving knowledge and skills correctly. Other areas of driver behaviour, such as not stopping at pedestrian crossings, traffic signals and stop signs were found to be due to poor attitudes rather than to poor knowledge. Although attitudes are notoriously difficult to change, there would seem to be some potential for improving them by introducing publicity and. enforcement campaigns. Another area of concern in some, but not all, Third World countries is the problem of alcohol and road-users. On-going research at TRL, has indicated from roadside random breath test surveys that in one country the proportion of weekend drivers sampled after 10.00pm with over 80mng alcohol/10OmI blood in their bodies is more than ten times that found in the United Kingdom. Thus, overall there are wide differences between developed and developing countries in the behaviour, knowledge, attitudes and culture of the road-users, in the conditions of the roads and the vehicles and in the characteristics of the traffic. Consequently the effectiveness of transferring some developed country solutions to developing countries is uncertain and their appropriateness needs to be considered in relation to the problems and conditions prevailing in individual countries. 8 4. INSTITUTIONS AND INFORMATION SYSTEMS 4.1 Organisational Requirements In road safety matters, as in many other sectors, there is a need to strengthen the various institutions responsible for the various aspects of road safety and to increase their capability for multi-sectoral action. The whole process of planning and implementing road safety improvements should be multi- disciplinary and dynamic. The setting of targets is a well established management strategy and, when applied to accident reductions, has proved very effective in many developed countries. A national target does need to be disaggregated so that all those with safety responsibilities are given their own specific and realistic targets with adequate funding directly related to those targets. To manage this efficiently, it is also recommended that the authorities produce an annual Road Safety Plan which clearly states the current accident reduction target and how it is to be achieved. These Plans should be published to provide higher authorities and the public with a valuable record of the efforts the authority is making (as well as its effectiveness in subsequent years) in improving the safety of the road network. Road safety organisations should thus be established on a full-time basis and be capable of: 1) diagnosing the road accident problem 2) drawing up an integrated plan of action including the setting up of goals and objectives 3) coordinating the work of all organisations involved 4) procuring funds and resources 5) producing design guides 6) designing and implementing improvements 7) monitoring implementation and evaluating measures 8) feeding back information from the evaluations and amending the action plan as necessary. In a survey of African countries' road safety activities (Yerrell, 1991) 35 per cent of the countries reported active national road safety organisations. Although this level of activity appears very encouraging, it should be noted that these reports were not independently verified. In many cases the functions of road safety organisations were somewhat limited and clearly more institutional improvements are still necessary in many countries. 4.2 Road Accident Databases One of the key activities listed above was the diagnosis of the road accident problem. The most important source of data for this activity is the police road accident report. In the early 1970s, a survey of road accident information systems in use in developing countries (Jacobs et al, 1975) indicated that only 15 per cent of the countries had adequate accident report forms and none had computer analysis facilities. Therefore, to help countries improve their accident investigation and research capability, TRL's Overseas Centre, with ODA's support, developed its Microcomputer Accident Analysis Package (MAAP), initially in collaboration with the traffic police in Egypt, (Hills and Elliott, 1986) and it is now in use in over 50 countries with 9 countries using it as their full national database. MAAP has been configured to operate in several languages including Arabic, 9 Chinese, French and Spanish. The software has been gradually developed and improved over the years, and it is interesting to no te that MAAP is also now used by a number of Police and Local Authorities in the UK. MAAP is a powerful yet simple system which enables users to: 1) obtain good data for diagnosis, planning, evaluation and research purposes 2) set up low-cost engineering improvement schemes similar to those which have proved so successful in developed countries. It consists of two key components: a police report booklet or form with a recommended structure, although details can vary considerably; and a set of software programs for data entry and analysis. The relatively low-cost and increased availability of microcomputers means that individual highway authorities can analyse their own data to help identify hazardous locations, the nature of the problems, choose appropriate countermeasures and assess their effectiveness, all with increased efficiency and, therefore it is hoped, accuracy. 5. IMPROVING ROAD SAFETY In the Third World, evaluation of improvements is essential because of the lack of data on the benefits (or otherwise) of road safety measures. It is recommended that improvements are introduced on a pilot basis and evaluated before being implemented nationwide. The Overseas Centre is giving priority to researching road safety counter- measures but, owing to the long term nature of many of the studies and the limited resources available, there are only a few published results. In spite of this lack of information the remainder of this paper attempts to give an idea of likely priorities for future road safety action and research by reviewing studies of remedial measures in developing countries with reference to developed country findings where appropriate. 5.1 Engineering and Planning Despite the fact that human error is probably the chief causal factor in most road accidents, there is little doubt that engineering and planning improvements can affect road-user behaviour in such a way that errors are less likely to occur or, when they do occur, the environment can be made more 'forgiving'. Thus, there has been a growth in emphasis on engineering and planning countermeasures over the past two decades both in Europe and North America. Engineering and planning can improve road safety through two distinct mechanisms: 1) ACCIDENT PREVENTION, resulting from good standards of design and planning of new road schemes and related development and 2) ACCIDENT REDUCTION, resulting from remedial measures applied to problems identified in the existing road network. 10 5.1.1 Accident prevention There has been very little research in developing countries into the relationships between highway design standards and accident rates. As a result, many developing countries have just adopted standards from developed countries or have modified such standards without evaluating the consequences. Often the traffic mix and road usage is very different in a developing country from that encountered in more industrialised countries. Also, there is usually a greater need to minimise costs; the challenge is to achieve this whilst at the same time maintaining an acceptable level of safety. To attain this balance, Hills et al (1984) have suggested that a radically different approach to the geometric design of highways may be required in developing countries, especially for low-volume roads. Studies of the relationships between geometric design and road accidents in Kenya and Jamaica (Jacobs, 1976) and research 'in Chile and India indicated, not unexpectedly, that junctions per kilometre was the most significant factor related to accidents, followed by horizontal and vertical curvature. Kosasihi, Robinson and Snell (1987) have examined geometric design research and standards around the world, and have made recommendations for developing countries. However, much more research is required before optimum standards can be determined for all developing countries. The TRL Overseas Centre currently has a research programme in Papua New Guinea that is examining the effects of certain highway design elements on accident rates, in particular the road cross-sectional profile. 5.1.2 Accident reduction The approaches used by developed countries for accident reduction would also seem to have considerable potential for developing countries. In particular, it is recommended that countries with limited resources should place initial emphasis on introducing low-cost improvement schemes at hazardous locations. Such schemes have proved very effective in industrialised countries; for example, in a survey of UK schemes (Hellier-Symons and Lynam, 1989) First Year Rates of Return were estimated to range from 65 to 950 per cent. A few developing countries have begun to introduce such schemes on a trial basis and the Overseas Centre is currently carrying out joint research to evaluate their effectiveness in Egypt, Ghana, Indonesia, Malaysia, Pakistan and Papua New Guinea. These trials, which have been made possible by the introduction of the TRL Microcomputer Accident Analysis Package (see earlier) are still at an early stage with many sites not yet improved. However, preliminary findings suggest that countries which have relatively low levels of road-user discipline are less likely to have success with very low- cost measures such as road signs and markings. For example, a study of the effects of introducing stop lines and lane lines at junctions and no overtaking lines at bends in Pakistan (Downing, 1985) indicated no improvements in driver behaviour apart from a small reduction in overtaking violations from 19 to 14 per cent. On the other hand, preliminary results from Papua New Guinea indicate that the introduction of roundabouts at uncontrolled major/minor junctions has halved the average injury accident rate (Hills et al, 1990). It has already been noted that, since the 1970s, industrialised countries have benefited considerably from improvements in engineering approaches to road safety. Developing countries on the other hand, have been slower to adopt these approaches. In many locations, roads are being built or upgraded with little consideration given to road safety, and as a result blackspots are still being created. One factor contributing to this situation could well be the difficulty in acquiring information 11 about the latest techniques and standards. To encourage the transfer of suitable technology in this field, the TRI, has published `Towards Safety Roads in Developing Countries" (TRRL, 1991), a road safety guide for planners and engineers. This was produced in association with the R~oss Silcock Partnership and is designed to be a first point of reference on road safety issues. It draws upon appropriate material from many existing manuals and standards around the world as well as giving many photographic examples of good and bad practices. There are certain fields of engineering where many design standards from developing countries could be applied directly now. One such application would appear to be in the area of street lighting, and a developing country manual has been published by the Institute of Lighting Engineers (ILE, 1990). The manual predicts night-time accident savings of over 30 per cent for road lighting improvements in Third World countries, although the costs of the improvements are relatively high compared with other measures. 5.2 Vehicle Safety Improvements in vehicle design, occupant protection and vehicle maintenance have made a significant contribution to accident reduction in industrialised countries. In developing countries, however,~ the safety design of vehicles sometimes lags behind that of developed countries, particularly when vehicles are locally manufactured or assembled. Similarly, vehicle condition is likely to be more of a problem when it is difficult to obtain spare parts. Overloading of goods and passenger vehicles is another vehicle factor which commonly contributes to high accident severity and casualty rates. The benefits to individual road-users of improving vehicle design and of wearing seatbelts and helmets are likely to be much the same from one country to another so the general adoption of both primary and secondary vehicle safety measures is to be encouraged. However, the total benefit of such measures to a developing country as a whole will depend on the characteristics of its accident and casualty problem and in some cases on the degree of road-users' compliance with traffic legislation. Thus, for example, seat belt wearing laws would lead to only small casualty savings if few casualties came from cars or if most drivers and passengers ignored the law. From Table 2 it is clear that the police in some developing countries have blamed a relatively high proportion (up to 17 per cent) of accidents on vehicle defects. Although many of these countries may have inadequate controls to ensure minimum safe standards of vehicle condition, it would seem more appropriate that they should start by introducing low-cost random roadside checks using simple equipment rather than expensive networks of vehicle testing centres with sophisticated technology. The control of overloading passenger-carrying vehicles combined with improvements in the design of such vehicles would also seem to have some potential for accident and casualty reduction in many countries. For example, in Papuia New Guinea (PNG), it is common for passengers to be transported in open pick-ups and, perhaps not surprisingly, an exceptionally high proportion (45 per cent) of the road accident casualties come from such vehicles. To help PNG deal with this problem, the Overseas Centre and Vehicle Safety Division of TRL designed a simple, robust protective cage to protect the occupants. Roll-over trials on TRL's test track demonstrated that the cage provided improved protection and it is planned that the design will be field tested in PNG. 12 5.3 Education and Training 5.3.1 Road Safety Education It is important for road-users to be educated about road safety from as young an age as possible. In developed countries a number of approaches have been tried both through school systems and through parents, and most children receive some advice. However, in developing countries where the child pedestrian accident problem is generally more serious (see Section 3. 1), a study of children' s crossing knowledge (Downing and Sayer, 1982) indicated that children were less likely to receive advice (from members of their family, teachers or the police) than in the UK. There is clearly a need to improve road safety education, but as some countries will have low school attendance figures it is important that education through community programmes is considered as well as through the school system. With respect to teaching methods, a number of studies in Europe (OECD, 1978) have evaluated teaching environments in terms of children's performances on crossing tests. Overall, the results demonstrated the importance of training on real roads; this need for frequent supervised practice on local roads close to where children live is likely to apply to all countries. It is recognised that road safety education programmes should be graded and developmental (OECD 1978, Downing 1987) and that teachers need guidelines on what and how to teach. To meet these requirements, many countries have produced syllabus documents and teacher guides, including a few in the Third World (Leburu, 1990). However, it is in this area that the transferability of developed country solutions to developing countries is less certain and much more research is needed. TRI, is currently developing material for use by teachers in Ghana so that the important concept of road safety education can be conveyed effectively to children at a relatively early age. 5.3.2 Driver training and testing In developing countries, the problems of poor driver behaviour and knowledge described earlier are likely to be due, to some extent, to inadequacies in driver training and testing. Professional driving instruction tends to be limited because: 1) driving instructors are not properly tested or monitored 2) there are no driving or instruction manuals 3) driving test standards and requirements are inadequate. Consequently, there is likely to be considerable scope for raising driving standards by improving driver training and testing. One recent contribution by the Overseas Centre in collaboration with the United Nations Economic Commission for Africa (ECA), is a driving guide specifically for truck drivers (TRRL, 1990). This group of drivers tends to have a greater involvement in accidents than in developed countries and inadequate training clearly plays some part in this. The guide was designed to be easy to read (average reading age of 9 years) and its usefulness appears promising, as a study by Downing (1991) demonstrated that reading sections of. the guide helped drivers improve their scores on knowledge tests by up to 25 per cent on some topics. 13 As well as providing such advice on driving standards, many countries need to improve the licensing, training, testing and monitoring of instructors to ensure that these standards are taught. In training systems where learner drivers are free to choose how they learn, it is important that driving tests demand a high standard of driving especially for the practical 'on the road' assessment. More difficult tests should encourage learners to purchase more lessons from professional instructors. As with other countermeasures, there has been little research on the effectiveness of improved driver training in developing countries and accident savings as a direct result of training are, of course, very difficult to prove. A study of a retraining course for bus drivers in Pakistan (Downing, 1988) failed to demonstrate any accident savings, although there was evidence of an improvement in knowledge test scores (13 per cent on average) and a reduction in driving test errors (67 per cent on average). It was also shown that the training had no effect on the drivers' behaviour when they were observed unobtrusively and they clearly returned to their old habits when driving in normal conditions. Therefore, to bring about a general improvement in driver behaviour it will usually be necessary to ensure that drivers are sufficiently motivated, and training courses will probably need to be integrated with publicity campaigns, incentive schemes and enforcement. 5.4 Enforcement A large number of studies (OECD, 1974 and Spolander, 1977) have examined the effectiveness of enforcement systems in developed countries, particularly with respect to traffic police operations. Many of them demonstrated that a conspicuous police presence led to improvements in driver behaviour in the vicinity of the police, but the evidence for accident reductions was less convincing. In developing countries, the traffic police are generally less well trained and equipped and often they are non-mobile ie stationed at intersections. Traffic police operating under such conditions are likely to find it difficult to influence moving violations and this was certainly shown to be the case in a study by Downing (1985) of the effects of police presence in Pakistan. However, studies of improved training and deployment of traffic police have indicated large reductions in moving violations (see Downing, 1985). Also, following the introduction of highway patrols on intercity roads, a 6 per cent reduction in accidents was achieved in Pakistan, and a similar scheme in Egypt produced accident reductions of almost 50 per cent (Gaber and Yerrell, 1983). Therefore,, it would appear that improvements in traffic policing have considerable potential for both improving driver behaviour and reducing accidents provided that the police's capability to enforce moving violations is enhanced. Research in developed countries (Mercer, 1985) suggests that changes in the way the traffic police operate need to be well advertised to ensure the maximum effect on road-user behaviour. This finding is likely to be universal and it is therefore equally important that developing countries integrate changes in enforcement tactics with appropriate publicity campaigns. In many Third World countries it is likely that such improvements will need to be accompanied by modification in both the traffic legislation and the ways of dealing with offenders. 6. CONCLUDING REMARKS Most high-income countries have had half a century to learn to. cope with the problems of ever- increasing motorisation. The less wealthy nations have had less, and for many the pace of change has been much greater. 14 Many developing countries have a se.rious road accident problem. Fatality rates are high in comparison with those in developed countries and whilst in Europe and North America the situation is generally improving, many developing countries face a worsening situation. Apart from the humanitarian aspects of the problem, road accidents cost countries of Africa and Asia at least one per cent of their Gross National Product each year -sums that these countries can ill afford to lose. Compared with causes of death more commonly associated with the developing world, deaths from road accidents are by no means insignificant. Lack of medical facilities in these countries has been shown to be an important factor leadingr to high death rates. In order to identify priorities for action, it is important that there is a clear understanding of the road accident problem and the likely effectiveness of road safety improvements. It is therefore a priority for countries to have an appropriate acc'l~ent information system (such as TRL' s MA.AP) which can be used to identify accident patterns, the factors involved in road accidents and the location of hazardous sites. In order that an overrall budget for, say, a five-year action programme can be determined, it is essential that developing countries set up procedures for costing road accidents. This will also do much to ensure that the best use is made of any investment and that the most appropriate improvements are introduced in termns of the benefits that they will generate in relation to the cost of _.their implementation. Other basic requirements for the lower and middle-income countries are likely to include the following, though this list may not be exhaustive:- I) Adapt a scientific, quanti2tive basis for road safety policy. Establish research centres, establish data systems and integrate with transport policy. ii) Create an institutional focus for road safety plans and actions which must be multi- disciplinary. Form road safety councils, train safety teams and establish realistic targets. iii) Press for long-term land-use and transport policies to reduce the use of the more dangerous modes and mixes of traffic. iv) Highways: plan well-defined hierarchies of use, reduce the unexpected on highways, institute safety audits, lowi-cost remedial works and low-speed/pedestrian priority areas in cities. v) Behaviour and training: target young road users. Legislate against and control drink (and drug)/driving. Improve targeted enforcement. vi) Vehicles: priority given to seatbelts, and to helmets for two-wheelers. In low-income countries, target public and parastatal freight and bus fleets (for general vehicle condition as well as other measures). vii) Improve emergency medical services for those who survive the first few minutes after a crash but die within the next few hours (often two-thirds), viii) With all measures, adopt., experiment and evaluate -and let the results be known and transferred on a national and international basis. is Developing countries have accelerated their efforts to improve road safety in recent years. It is hoped that these trends will continue and that all countries will, through joint programmes of research and development and by sharing information, maintain an effective and scientific approach to reducing road accidents throughout the world. 7. ACKNOWLEDGEMENTS The work in this paper forms part of the programme of the Transport Research Laboratory and the paper is published by permission of the Chief Executive. 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